When does metabolic memory start? Insights from the AMD Annals Initiative on stringent HbA1c targets.

IF 6.2 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes Pub Date : 2024-10-17 DOI:10.2337/db24-0166

Giuseppina T. Russo, Antonio Nicolucci, Giuseppe Lucisano, Maria Chiara Rossi, Antonio Ceriello, Francesco Prattichizzo, Valeria Manicardi, Alberto Rocca, Paolo Di Bartolo, Salvatore De Cosmo, Graziano Di Cianni, Riccardo Candido

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引用次数: 0

Abstract

Early, intensive glycemic control in T2D patients is associated with long-term benefits on cardiovascular disease (CVD) development. Evidence on benefits of achieving HbA1c targets close to normal values is scant. Subjects with newly-diagnosed T2D, without CVD at baseline, were identified in an Italian clinical registry (N=251,339). We adopted three definitions of early exposure periods (0–1, 0–2 and 0–3 years). Mean HbA1c was categorized into HbA1c < 5.7%, 5.7-6.4%, 6.5-7.0%, 7.1-8.0%, and >8.0%. The outcome was the incidence of major cardiovascular events. After a mean follow-up of 4.6±2.9 years, at multivariate Cox regression analysis, compared with mean HbA1c <5.7% during the first year after diagnosis, the increase in the risk of CVD was 24%, 42%, 49% and 56% for patients with HbA1c of 5.7%-6.4%, 6.5%-7.0%, 7.1%-8.0%, and >8.0%, respectively. The same trend was documented in all exposure periods. In conclusion, our data support that an early achievement of stringent targets of HbA1c <5.7% is worthy for CVD prevention.

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代谢记忆何时开始？AMD 年报倡议对严格 HbA1c 目标的启示。

早期强化控制 T2D 患者的血糖与心血管疾病（CVD）发展的长期益处相关。关于实现接近正常值的 HbA1c 目标所带来的益处的证据还很少。我们从意大利临床登记处（N=251,339）中找到了基线时无心血管疾病的新诊断 T2D 受试者。我们采用了三种早期暴露期（0-1 年、0-2 年和 0-3 年）的定义。平均 HbA1c 分为 HbA1c <5.7%、5.7-6.4%、6.5-7.0%、7.1-8.0% 和 >8.0%。结果是重大心血管事件的发生率。平均随访 4.6±2.9 年后，经多变量 Cox 回归分析，与确诊后第一年的平均 HbA1c <5.7%相比，HbA1c 为 5.7%-6.4%、6.5%-7.0%、7.1%-8.0% 和 >8.0% 的患者发生心血管疾病的风险分别增加了 24%、42%、49% 和 56%。所有暴露期都有相同的趋势。总之，我们的数据支持尽早实现 HbA1c &;lt;5.7%的严格目标，这对于预防心血管疾病是值得的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes 医学-内分泌学与代谢

CiteScore

12.50

自引率

2.60%

发文量

1968

审稿时长

1 months

期刊介绍： Diabetes is a scientific journal that publishes original research exploring the physiological and pathophysiological aspects of diabetes mellitus. We encourage submissions of manuscripts pertaining to laboratory, animal, or human research, covering a wide range of topics. Our primary focus is on investigative reports investigating various aspects such as the development and progression of diabetes, along with its associated complications. We also welcome studies delving into normal and pathological pancreatic islet function and intermediary metabolism, as well as exploring the mechanisms of drug and hormone action from a pharmacological perspective. Additionally, we encourage submissions that delve into the biochemical and molecular aspects of both normal and abnormal biological processes. However, it is important to note that we do not publish studies relating to diabetes education or the application of accepted therapeutic and diagnostic approaches to patients with diabetes mellitus. Our aim is to provide a platform for research that contributes to advancing our understanding of the underlying mechanisms and processes of diabetes.